Precuneus activity during retrieval is positively associated with amyloid burden in cognitively normal older carriers.

The precuneus is a site of early amyloid-beta (Aβ) accumulation. Previous cross-sectional studies reported increased precuneus fMRI activity in older adults with mild cognitive deficits or elevated Aβ. However, longitudinal studies in early Alzheimer's disease (AD) are lacking and the relationship to the Apolipoprotein-E () genotype is unclear.

Digital Foetal Scalp Stimulation Versus Foetal Blood Sampling to Assess Foetal Well-Being in Labour: A Multicentre Randomised Controlled Trial.

Objective: To establish whether digital foetal scalp stimulation (dFSS) performs better than foetal blood sampling (FBS) in terms of reducing the rate of caesarean section (CS) in labour, without adversely affecting perinatal outcomes.

Design: A multicentre parallel-group randomised controlled trial.

Setting: Maternity centres in Ireland.

The role of neutrophils in allergic disease.

Neutrophils are short-lived cells of the innate immune system and represent 50-70% of the circulating leucocytes. Their primary role is antimicrobial defence which they accomplish through rapid migration to sites of inflammation followed by phagocytosis, degranulation, and the release of neutrophil extracellular traps (NETosis). While previously considered terminally differentiated cells, they have been shown to have great adaptability and to play a role in conditions ranging from cancer to autoimmunity.

Stochastic modeling of single-cell gene expression adaptation reveals non-genomic contribution to evolution of tumor subclones.

Cancer progression is an evolutionary process driven by the selection of cells adapted to gain growth advantage. We present a formal study on the adaptation of gene expression in subclonal evolution. We model evolutionary changes in gene expression as stochastic Ornstein-Uhlenbeck processes, jointly leveraging the evolutionary history of subclones and single-cell expression data.

Children's rights and wrongs: respect, equality and dignity.

Despite the almost global ratification of the United Nations Convention on the Rights of the Child, Ireland and the international community fall short on the full realisation of these standards. Among the many pervasive and enduring failures are the persistence of child poverty, inadequate access to healthcare services, inequality of access to education, and continued discrimination based on race, ethnicity, gender, and disability. A highly relevant concern in today's world is the increasing exposure of children to armed conflict and our inability to effect change.

Providers Paid Substantially Less By Marketplace Nongroup Insurers Than By Employer Small-Group Plans, 2021.

Numerous studies show that employer plans pay providers significantly more than Medicare, but less is known about prices in nongroup plans sold both on and off the Marketplaces established by the Affordable Care Act (ACA), where narrow networks and low-cost insurers are more prevalent. We estimated prices for three market segments (Marketplace nongroup, off-Marketplace nongroup, and employer small group) and three types of services (professional, outpatient hospital, and inpatient hospital) relative to a Medicare benchmark. We used 2021 claims data covering virtually all enrollment in ACA risk-adjusted plans.

Cerebral hyperactivation across the Alzheimer's disease pathological cascade.

Neuronal dysfunction in specific brain regions or across distributed brain networks is a known feature of Alzheimer's disease. An often reported finding in the early stage of the disease is the presence of increased functional MRI (fMRI) blood oxygenation level-dependent signal under task conditions relative to cognitively normal controls, a phenomenon known as 'hyperactivation'. However, research in the past decades yielded complex, sometimes conflicting results.

Beyond 'spray on' professional development: Enhancing supervision in a tertiary teaching hospital.

Background: Short 'programmes' of professional development can have limited impact on clinical supervisors' practices. This paper reports on an innovative programme of professional development, implemented in a tertiary teaching hospital, that was designed to build clinical supervision capacity, improve the educational practice of frontline clinical supervisors and cultivate future educational leaders.

Approach: The programme was a partnership venture between St.

Altered sleep and inflammation are related to outcomes in neonatal encephalopathy.

Aim: Immune dysregulation and delayed onset of sleep wake cycling (SWC) are associated with worse outcome in neonatal encephalopathy (NE), however the association between sleep and immune dysfunction in NE remains unclear. Aimed to evaluate association of sleep and systemic inflammation with outcomes in NE.

Methods: Amplitude-integrated electroencephalography (aEEG) recordings were collected on infants undergoing therapeutic hypothermia (TH).

The stigma of underperformance in assessment and remediation.

The stigma of underperformance is widely acknowledged but seldom explored. 'Failure to fail' is a perennial problem in health professions education, and learner remediation continues to tax supervisors. In this study, we draw on Goffman's seminal work on stigma to explore supervisors' accounts of judging performance and managing remediation in specialty anesthesia training in Australia and New Zealand.

Trainees as teachers: Building evaluative judgement through peer teaching.

Introduction: While peer teaching is often seen as benefiting learners, it can also benefit peer teachers. One possible mechanism is by building peer teachers' evaluative judgement or their ability to judge the quality of work of selves and others. This qualitative interview study explores how specialty medical trainees build evaluative judgement through peer teaching.

Near-Peer Coaching to Enhance Operative Learning: An Educational Innovation for Surgical Training.

Objective: To design, implement, and evaluate a near-peer coaching model to enhance operative learning in general surgery training.

Background: There is an urgent need to maximize operative learning in surgical education. Trainees find barriers to operative learning difficult to navigate and often sacrifice educational opportunities for the sake of impression management.

Causes and Terminology in Neonatal Encephalopathy: What is in a Name? Neonatal Encephalopathy, Hypoxic-ischemic Encephalopathy or Perinatal Asphyxia.

Neurologic depression in term/near-term neonates (neonatal encephalopathy, NE) is uncommon with modern obstetric care. Asphyxial birth, with or without co-factors, accounts for a minority of NE, while maldevelopment (congenital malformations, growth aberrations, genetic, metabolic and placental abnormalities) plays an enlarging role in identifying etiologic subgroups of NE. The terms NE and hypoxic-ischemic encephalopathy (HIE) have not been employed uniformly, hampering research and clinical care.

Neonatal bacterial sepsis.

Neonatal sepsis remains one of the key challenges of neonatal medicine, and together with preterm birth, causes almost 50% of all deaths globally for children younger than 5 years. Compared with advances achieved for other serious neonatal and early childhood conditions globally, progress in reducing neonatal sepsis has been much slower, especially in low-resource settings that have the highest burden of neonatal sepsis morbidity and mortality. By contrast to sepsis in older patients, there is no universally accepted neonatal sepsis definition.

Respiratory syncytial virus NS1 inhibits anti-viral Interferon-α-induced JAK/STAT signaling, by limiting the nuclear translocation of STAT1.

Human respiratory viruses are the most prevalent cause of disease in humans, with the highly infectious RSV being the leading cause of infant bronchiolitis and viral pneumonia. Responses to type I IFNs are the primary defense against viral infection. However, RSV proteins have been shown to antagonize type I IFN-mediated antiviral innate immunity, specifically dampening intracellular IFN signaling.

Bronchiolitis: evidence-based management in high-risk infants in the intensive care setting.

Aim: Systematically review the management of infants with severe bronchiolitis in a paediatric intensive care unit (PICU) setting with a focus on high-risk infants to identify gaps in evidence-based knowledge.

Methods: This systematic review utilised Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) to examine the literature on the PICU management of bronchiolitis in infants <24 months old. Three databases, Embase, PubMed and Medline, were searched and higher levels of evidence I, II and III were included.